Causes of Medical Coma in Adult Patients at the University College Hospital, Ibadan Nigeria

Abstract

Diseases of medical origin leading to coma account for 3-15% of emergency hospital admissions in developed countries. There is dearth of data on causes of medical coma in adults in Nigeria in particular and Africa in general. This study is to determine the causes of coma in adult patients admitted at the medical emergency unit and wards of the University College Hospital (UCH) Ibadan. A prospective study of two hundred consecutive adult unconscious patients seen at the medical emergency unit of UCH, Ibadan, from August 2004 to March 2005, was undertaken using a structured clinical history and physical examination protocol, and results of relevant diagnostic investigations, including post-mortem. Medical causes of coma constituted 10% of all emergencies and 3% of total hospital admissions respectively during the 8-month period. Sixty six percent were males. The age group 20-59 years were affected most (76.5%). Four commonest causes were: Acute stroke 33%), diabetic emergencies (12.5%), uraemic encephalopathy and meningitides (11% each). Four least causes were cerebral malaria (1.0%), hypertensive encephalopathy, alcohol and gamalline poisoning (0.5% each). Four common predisposing factors which also had significant male predominance were systemic hypertension (38.5%), diabetes mellitus (14%), alcohol and substance abuse (12.5%), and HIV/AIDS (11.5%). Hypertensive stroke and diabetic coma constituted the commonest medical causes of coma. Thus preventive measures such as public health enlightenment campaigns for lifestyle modifications, routine blood pressure and glucose examinations are necessary to avert their disastrous consequences.